Student Observations and Feedback

* G… Get Ready

• Review course expectation
• Review Evaluation Form
• Consider unique Opportunities/Challenge of your site
• What are your Expectations for the learner?

* R… Review Expectations with Learner

• Meet very early in experience.
• Determine knowledge/skill level.
• Review: Program Goals, Your Goals, Learner’s Goals
• Describe the Evaluation Process

* A… Assess

• Observe
• Record
• Provide Feedback Regularly
• Have Learner Self-Assess

* D… Discuss Assessment at Mid-Point

• Formal Meeting
• Learner and evaluator fill out form in advance
• Compare evaluations together.
• Discuss differences and how expectations are being met.

* E…End with a “Grade”

• Complete evaluation in advance
• Schedule sufficient time
• Support your evaluation with specific examples

Observation is a powerful technique to understand what a student knows and what he/she could do to improve.  Finding time to observe a student may seem difficult, but just two minutes of observation can yield sufficient information to provide valuable, constructive feedback.

Richard Sarkin, MD (University at Buffalo School of Medicine and Biomedical Sciences) and LuAnn Wilkerson, Ed.D. (UCLA School of Medicine), suggest the following for conducting two-minute observations.

1. Explain the purpose of the observation to the student.
2. Tell the student how the observation will take place.
3. Let patient know that a brief observation may take place (student or preceptor explains).
4. Conduct observation at the beginning or in the middle of a student’s time with the patient for two minutes without interrupting.
5. Try to leave room without disrupting the student/patient encounter.
6. Quickly jot notes about what you observed.
7. Provide specific feedback to the student as close to the observed encounter as possible.
8. Set an agenda with the student for future learning.

Formative Feedback

Formative feedback helps both the student and the teacher.  It is a way of assessing student learning so the instructor knows whether more teaching, or more review is necessary.  It lets all concerned know when the learner is ready for assessment or evaluation.  It actually lets the teacher know how well they have taught.  Assessment results inform the teacher of what has been taught well and not so well. They inform students of what they have learned well and not learned so well.

Formative feedback is used to help the student learn and is not counted toward the grade.  Our students do not receive a grade, per se, for OPEX anyway.  This type of feedback actually helps students get the best learning experience possible.  Formative assessments are a way of adapting to student needs.

As opposed to a summative assessments designed to make judgments about student performance and produce grades, the role of a formative assessment is to improve learning. As opposed to benchmark tests that are used to predict student performance on other tests (most often state assessments), formative assessments are intimately connected to instruction.

Formative assessments are:

For Learning – The purpose of formative assessment is to enhance learning not to allocate grades. Summative assessments are designed to allocate grades. The goal of formative assessment is to improve; summative assessment to prove.

Embedded in Instruction - Formative assessments are considered a part of instruction and the instructional sequence. What students are taught is reflected in what they are assessed.  For example, we want to know that the students can take a thorough and appropriate history and perform an appropriate physical exam. 

Formative assessments produce:

Non-threatening Results - Formative assessments are scored but not graded. Students mark their own work and are encouraged to raise questions about the assessment and the material covered by the assessment, all for the purposes of self-improvement.

Direct and Immediate Feedback- Results of formative assessments are produced “on the spot;” teachers and students get them immediately. Teachers get a view of both individual and class performances while students learn how well they have done.

Structured Information - Teachers can judge success and plan improvements based on the formative results. Students can see their progress and experience success. Both teachers and students learn from the assessment results.  In our situation, the physician will be seeing the results of skills taught by himself and others. 

Ways to Improve - Summarized formative results provide a basis for the teacher to re-visit topics in the unit if necessary. Individual student responses provide a basis for giving students additional experiences in areas where they performed less well.

Writing Comments

Your “comments” do not have to be an eloquent recommendation letter; we just need some of your observations.  If a student does a good job and you think highly of him or her or of their work, tell us why.   If you have concerns, we need to know that also.  Your comments should be based on behavior.

You may find it helpful to keep a sheet about each of your students in a secure but accessible location, and when someone does something really good, make a note about it and date it.  For example, if the student heard a murmur or made a good pick-up from the history or on a patient’s physical exam, jot it down.  You can send us a copy of your notes at the end of the quarter or year.

You may also use your dated notes to write down concerns that you have.  That way it will be easier to allow the student to see their inevitable progress. 

Feedback

Reminder:  the students continue to say that they desire more feedback.  They do not think that they are getting any/enough feedback from their preceptors.  So, preceptors, please try the following:

• Announce to the students that you are about to give them some feedback.
• Use the sandwich approach – give positive comments, note areas needing improvement, end on positive note
• Follow with the comment that you have just given them feedback.

• Identify the educational purpose
• Find someplace private
• Focus on an observed behavior
• Speak in the first person
• Encourage self-assessment
• Utilize the positive-negative-positive approach
• Be specific and timely
• Keep it simple and slow
• Negotiate and action plan
• Plan for follow-up feedback

Aim to provide feedback on a routine basis. The more often you provide feedback, the easier it becomes.

Give Feedback to Help Learners IMPROVE

I   –  Identify and discuss objectives with learner

M –  Make a feedback-friendly environment

P –  assess Performance;  Prioritize the feedback you give

R –  Respond to the learner’s self-assessment

O –  Be Objective: report specific behaviors observed; describe potential

V –  Validate what the learner has done well or suggest other strategies

E –  Establish a plan to implement changes (if needed); have learner summarize feedback and plan